Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicole Marie Liedtke, LCSW, LCAC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1740505460

Nicole Marie Liedtke, LCSW, LCAC is a Clinical Social Worker in Fishers, Indiana. Qualified in 2006, 20 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Indiana.

Years since qualifying
20
Licensed in
IN
In the registry since
2010
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

14074 Trade Center Dr Ste 220
Fishers, IN 46038-4575
Phone: (317) 775-7797
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 34005950A (IN)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 87001005A (IN)

Record details

NPI number1740505460
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW , LCAC
Sole proprietorYes
NPI enumeratedApril 6, 2010
Last updated in NPPESDecember 10, 2020
Certification dateDecember 10, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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